According to the new guidance, non-grandfathered plans must cover all FDA-approved contraceptives prescribed by the member’s provider without cost-sharing not just oral contraceptives. The guidance also provides that consistent with past guidance a plan may use reasonable medical management techniques to control costs. For example, a plan could cover generic contraceptives at 100% but imposing cost sharing on equivalent brand names. However, the plan must have a process for waiving the cost-sharing if the generic drug would be medically inappropriate as determined by the member’s provider.

The new guidance also provides information on other preventative care issues, including well-woman visits, breastfeeding counseling, domestic violence screening and polyp removals performed during colonoscopies.